COVID-19 infection and pulmonary sarcoidosis: a systematic review and meta-analysis of morbidity, severity and mortality.

Background: The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) influenced millions of lives, not only healthy subjects but also patients with various comorbidities. Of those, interstitial lung disease (ILD) is known to be specifically vulnerable to SARS-CoV-2, sometimes leading to a lethal outcome. Sarcoidosis, one of the ILDs, has been suggested to be more susceptible to COVID-19, but the results of previous studies are in disagreement. Methods: We performed a meta-analysis, attempting to explain the correlation between COVID-19 and sarcoidosis. Electronic databases were searched and selected for analysis under pre-established criteria. Risk ratio (RR) for incidence and odds ratio (OR) for severity, i.e., intensive care unit (ICU) admission and death, were calculated with (95%) confidence interval (CI) using R Statistical Software (version 4.3.1). Results: The RR of COVID-19 incidence on sarcoidosis patients was 5.86 (95% CI: 8.02-11.91). Admission of sarcoidosis patients to the ICU who were infected with SARS-CoV-2 was 2.48 (95% CI: 2.04-3.01). Death of sarcoidosis by COVID-19 was also significantly higher compared with healthy controls (OR =1.95, 95% CI: 1.58-2.41). Both morbidity and mortality due to COVID-19 was significantly higher in the sarcoidosis patients. Conclusions: Sarcoidosis patients are undeniably prone to SARS-CoV-2 infection, with increased severity, morbidity and greater mortality of COVID-19. Vaccination against SARS-CoV-2 for sarcoidosis therefore is beneficial, and may be a compulsory measure. Further studies regarding other factors are needed for a better understanding of the correlation between sarcoidosis and COVID-19.